When cancer time-trend data are examined by site, higher mortality and lower survival rates are found among the black population. Early detection of cancer is believed to be less frequent among minority populations. Documentation of poorer cancer awareness suggests a causal linkage between awareness and early detection. Our goal is to improve cancer survival among black men and women aged 50 to 70 in a geographically defined area in Northern Alameda County, California. We aim to: 1) increase cancer awareness and cancer prevention practices among members of this population; 2) increase cancer prevention behaviors; 3) decrease the lag-time between identification of a suspicious sign and medical follow-up; and 4) decrease the stage at which digestive and reproductive cancers are diagnosed. To increase the probability that knowledge gains will lead to behavior change, we have designed an information and referral system that utilizes innovative engagement mechanisms. First, we plan to develop health messages regarding cancer symptoms for use in a Tel-Med system. An advice nurse will act as a backup to the system and will refer individuals for medical diagnosis or provide information on preventive measures. Second, we will organize and train individuals in such community groups as churches, clubs, and fraternal organizations to be advice givers within specific social networks and to make referrals to the Tel-Med system. Third, we will work with the provider community to increase sensitivity to cancer detection. Two methods of evaluation are proposed: in one, a pre-post design with a comparison group will be used; surveys in both study and comparison areas in years 1 and 5 will assess changes in cancer awareness and use of cancer prevention practices. To determine whether the objectives of the health education intervention have occurred, a comparison of pre and post results in these two will be conducted. This approach will help to determine whether our program was effective in increasing the earliness of detection for specified cancer sites. In this analysis, data for specified cancer sites in our target area will be compared to the entire San Francisco Bay Area.